Hospital execs: Meaningful Use, interoperability discussions can't be separated

Provider-based health IT professionals stated their case for why they need more flexibility for Meaningful Use Stage 2 during a briefing at the Russell Senate Building in the District of Columbia on Tuesday.

The often tension-filled discussion, hosted by the College of Healthcare Information Management Executives, included hospital CIOs Randy McCleese of Morehead, Kentucky-based St. Claire Regional Medical Center and Marc Probst of Salt Lake City-based Intermountain Healthcare, as well as Peter Basch, medical director for ambulatory EHR and health IT policy at MedStar Health in the nation's capital; William Bria, president of the Association of Medical Directors of Information Systems; and ONC Interoperability Portfolio Manager Erica Galvez.

Following comments from Galvez that Meaningful Use is only "one lever" in the push for interoperability and that the industry needs to "shift the conversation from being so Meaningful Use-centered to thinking about other business drivers," Probst (pictured right) said that as much as he'd like to, separating the incentive program and interoperability conversations isn't an option.

"We can't ignore Meaningful Use" because of the incentives and penalties, Probst said. "If indeed we do move on Oct. 1 with a 365-day reporting period ... it leaves very little flexibility. I know we want to move the discussion from Meaningful Use ... but it is part of the discussion and it does make it a challenge to move to this next part of the discussion. ... We're still making decisions about Meaningful Use Stage 3 that we have yet to introduce to the population. I don't think we can ignore the fact that Meaningful Use is sitting over" our heads.

Basch's comments echoed Probst's.

"When we as providers stop thinking about [flexibility] and we do things that make sense for us as a practice or specialty, we may find ourselves in the penalty phase of Meaningful Use," Basch (pictured left) said. "We have to take some of the barbs of the penalty phase of Meaningful Use out so that we allow innovation to occur."

When asked about vendor satisfaction in the wake of Meaningful Use, Basch said that while he understands many doctors are unhappy with their EHRs, he can't blame vendors for that situation.

"EHR vendors build for a market," Basch said. "They're not villainous. ... Until we change the business model for healthcare, it's hard to hold our vendors culpable."

Probst agreed.

"The reality is, these things are complex," he said. "It's going to take some work for them to get interoperable so we can share data. Where's the recipe for Epic and Cerner to talk to each other? I just think we haven't given them the recipe for how to do it. I don't look at them as the evil people in this process."

To that end, Probst advocated for the government-led creation and implementation of interoperability standards, which he's talked about time and again.

"It does all come down to these fundamental standards," Probst said. "If we want to be able to move data from one system to another, technically, that isn't all that hard … the hard part is actually doing it--making that decision" to create and implement standards.

"We've got to sit down and say 'what's the standard? How are we going to move it?'" Probst continued. "When we do that, [doctors and researchers] are going to do things that blow [ONC's interoperability vision] out of the water. It's going to be so much better. And it'll lower costs and make quality higher."

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